Performing analytics on protected health information

ABSTRACT

This disclosure includes techniques for analyzing patient data. In one example, a method includes accessing, by a computer system, one or more databases comprising health information, with protected health information, for a plurality of patients, accessing, by the computer system, an analytical model, and receiving, by the computer system via a user interface, instructions to apply the analytical model to health information for each of the plurality of patients. The protected health information is isolated from the user interface to restrict access to the protected health information. The method further includes applying, by the computer system, the analytical model to health information for each of the plurality of patients, and storing a result of the analytical model to the one or more databases.

TECHNICAL FIELD

This disclosure relates to techniques for analytic modeling of healthinformation.

BACKGROUND

In the medical field, accurate processing of records relating to patientvisits to hospitals and clinics ensures that the records containreliable and up-to-date information for future reference. Accurateprocessing may also be useful for medical systems and professionals toreceive prompt and precise reimbursements from insurers and otherpayers. Some medical systems may include electronic health record (EHR)technology that assists in ensuring records of patient visits and filesare accurate in identifying information needed for reimbursementpurposes. These EHR systems generally have multiple specific interfacesinto which medical professionals may input information about thepatients and their visits.

The patient files within the EHR usually include protected healthinformation (PHI). PHI represents personal information to which limitedaccess is desirable and often required by government laws andregulations, such as the Health Insurance Portability and AccountabilityAct of 1996 (HIPAA) and Health Information Technology for Economic andClinical Health (HITECH) in the United States. Similar laws to restrictaccess to PHI exist in many other countries.

SUMMARY

In general, this disclosure describes techniques for analytic modelingof PHI in a way that can limit user access to the PHI. In this manner,the PHI can be sheltered from view by the user so as to ensure itsprotected status. Accordingly, the techniques may improve the ability toensure privacy of patients, and may be useful for legal or regulatorycompliance.

In one example, this disclosure is directed to a method for analyzingpatient data. The method includes accessing, by a computer system, oneor more databases comprising health information for a plurality ofpatients, wherein the health information includes protected healthinformation, randomly selecting, by the computer system, a subset of thehealth information from the one or more databases, wherein the subset ofthe health information corresponds to a subset of the plurality ofpatients, removing, by the computer system, the protected healthinformation from the subset of health information to produce ade-identified analytics subset of patient data suitable for analyticalmodel construction and evaluation, and storing, by the computer system,the de-identified analytics subset of the patient data in the one ormore databases.

In another example, this disclosure is directed to a computer system forstoring and analyzing health information for a plurality of patientscomprising one or more databases comprising health information for aplurality of patients, wherein the health information includes protectedhealth information, and health information, for a randomly-selectedsubset of the plurality of patients within the protected healthinformation removed for the randomly-selected subset of the plurality ofpatients, and a user interface that facilitates user access to healthinformation for a randomly-selected subset of the plurality of patientswithin the protected health information removed for therandomly-selected subset of the plurality of patients for analyticalmodel construction and evaluation.

In a further example, this disclosure is directed to a computer-readablestorage medium comprising instructions that, when executed, cause aprocessor to access one or more databases comprising health informationfor a plurality of patients, wherein the health information includesprotected health information, randomly select health information fromthe one or more databases corresponding to a subset of the plurality ofpatients, remove the protected health information from the healthinformation corresponding to the randomly-selected subset of theplurality of patients to produce a de-identified analytics subset ofpatient data suitable for analytical model construction and evaluation,and store the updated de-identified analytics subset of patient data inthe one or more databases.

In another example, this disclosure is directed to a method foranalyzing patient data. The method includes accessing, by a computersystem, one or more databases comprising health information, withprotected health information, for a plurality of patients, accessing, bythe computer system, an analytical model, and receiving, by the computersystem via a user interface, instructions to apply the analytical modelto health information for each of the plurality of patients. Theprotected health information is isolated from the user interface torestrict access to the protected health information. The method furtherincludes applying, by the computer system, the analytical model tohealth information for each of the plurality of patients, and storing aresult of the analytical model to the one or more databases.

In another example, this disclosure is directed to a computer system forstoring and analyzing health information for a plurality of patientscomprising one or more databases comprising health information, withprotected health information, for a plurality of patients, a userinterface, and a processor configured to apply an analytical model topatient data for each of the plurality of patients based on instructionsreceived via the user interface, and storing a result of the analyticalmodel to the one or more databases. The protected health information isisolated from the user interface to restrict access to the protectedhealth information.

In a further example, this disclosure is directed to a computer-readablestorage medium comprising instructions that, when executed, cause aprocessor to access one or more databases comprising health information,with protected health information, for a plurality of patients, receive,via a user interface, instructions to apply an analytical model tohealth information for each of the plurality of patients, apply theanalytical model to health information for each of the plurality ofpatients, and store a result of the analytical model to the one or moredatabases. The protected health information is isolated from the userinterface to restrict access to the protected health information.

The details of one or more examples of this disclosure are set forth inthe accompanying drawings and the description below. Other features,objects, and advantages will be apparent from the description anddrawings, and from the claims.

BRIEF DESCRIPTION OF DRAWINGS

FIG. 1 is a block diagram illustrating an example of a computer systemconfigured for analytic modeling of health information, such as healthinformation including protected health information (PHI).

FIG. 2 is a conceptual illustration of a data service interface and thecombined data storage system storing health information, such as healthinformation including PHI.

FIG. 3 illustrates example techniques for producing a de-identifiedanalytics subset of patient data suitable for analytical modelconstruction and evaluation.

FIG. 4 is an operational diagram representing analyst interaction with acomputer system that logs analyst access to PHI within the healthinformation to facilitate compliance with patient privacy laws.

FIG. 5 is an operational diagram representing analyst interaction with acomputer system that facilitates analytic modeling of health informationwhile restricting analyst access to PHI within the health information.

FIG. 6 is an operational diagram representing analyst interaction with acomputer system that facilitates updating of health informationassociated with a plurality of patients while restricting analyst accessto PHI within the health information.

FIG. 7 is a flow diagram illustrating an example technique for producinga de-identified analytics subset of health information suitable foranalytical model construction and evaluation.

FIG. 8 is a flow diagram illustrating example techniques for analyzinghealth information associated with a plurality of patients whilerestricting access to PHI within the health information.

DETAILED DESCRIPTION

Healthcare may be improved through the application of big dataanalytics. As referred to herein, big data analytics refers to the useof statistical analytics in contexts where the data volume is verylarge, such as where the data volumes are so large that the volumeitself is a problem. However, the analysis of healthcare information isgreatly complicated by the need to limit access to protected healthinformation (PHI) and satisfy the requirements of HIPAA and HITECH andsimilar laws and regulations across the globe. In particular, the use ofbig data analytics inherently requires analyzing very large quantitiesof data, and general big data techniques result in analysts viewinglarge subsets of the data, risking violating patient privacy laws,regulations, or causing other privacy concerns.

Patients may be asked to waive their privacy rights to producesignificant quantities of data available for analytics, essentiallybypassing the PHI restrictions. However, such techniques necessarilyrequire a significant time investment to ask for patient waivers andthen separate the patent data for which privacy rights have been waivedbefore applying big data analytics to the patient data. In some cases,only a small fraction of patients are willing or can be reached to waiverestrictions, which reduces the effectiveness of analytics as datavolume is associated with accuracy.

In other examples, the entire data set, i.e., the patient data includingPHI for all patients within a database may be located within a securedenvironment for applying big data analytics to the patient data. Undersuch examples, the system may rely on a surrounding “firewall” andassuming that those authorized to work within the firewall haveunlimited access. However, such examples may create difficulties incompliance with patient privacy laws. Patient privacy laws may includerequirements for logging user access to patient data and blocking accessto data across healthcare systems. Another problem with such techniquesis the common analytics practice of copying data as part of the analysis(e.g., download the data to another processor) for analytical modelbuilding and evaluation. Patient privacy laws often require carefultracking of where all of the copies of PHI are located and how and whenthey are accessed, and by whom. Compliance with these laws may be verydifficult with data copied to files for analytics in general-purposeanalysis engines.

Causes of PHI violations may occur with when those “other processors”are lost. Examples include laptops that go missing with PHI or even ahard drive on a copier that was disposed of without being wiped. Anytime data moves out of the “secure” processors, there is a risk that allcompliance monitoring is bypassed.

Furthermore, using a firewall for a group of patients within a databasefor a single healthcare institution may prevent combining data withother databases of patient data. This can limit the ability to developanalytical models as statistical analysis benefits greatly fromincreased data volumes, so further value can be derived from analyticsacross multiple providers than from any single provider. In particular,for every factor of four increase in data volumes, the standard errordecreases by a factor of two.

In another example, patient data within a database may be de-identifiedor “anonymized” before making it available for analytics. However, suchtechniques may create difficulties with the data analysis. For example,some of the patient-identifying information may in fact be relevant tothe development and application of analytical models, thus de-identifieddata may be potentially less effective to deliver value. As anotherexample, there is no perfect solution for de-identifying unstructureddata such as narrative text or images, though a substantial majority ofall valuable healthcare data is in unstructured form.

These and other examples for enabling big data analytics while complyingwith patient privacy laws are disclosed herein. In general, the mostvaluable techniques for enabling big data analytics, while complyingwith patient privacy laws, attempt to utilize the large data volumesavailable for development and application of analytical models as wellas mitigate the data quality issues associated with de-identification,and reduce the exposure of PHI to human analysts.

FIG. 1 is a block diagram illustrating an example of a computer systemfor analytic modeling of health information, such as health informationincluding protected health information (PHI). Computer system 110includes processor 112, at least one database 114, and user interface140. Computer system 110 may also include other components and modulesrelated to the processes described herein and/or other processes. Insome examples, the components of computer system 110 may be distributedacross one or more networks, such as a local area network (LAN) and/orthe internet. The illustrated components are shown as one example, butother examples may be consistent with various aspects described herein.

User interface 140 may be configured to output information to a user orother device. For example, user interface 140 may include a displayscreen for presenting visual information to a user. In other examples,user interface 140 may include one or more different types of devicesfor presenting information to a user. Database 114 may comprise one ormore memories or other storage units configured to store healthinformation 130 for a plurality of patients, which may include datastored within documents such as patient medical records. Healthinformation 130 includes PHI 132 for at least some of the plurality ofpatients. PHI 132 may be subject to patient privacy regulations.

Processor 112 may include a general-purpose microprocessor, a speciallydesigned processor, an application specific integrated circuit (ASIC), afield programmable gate array (FPGA), a collection of discrete logic,and/or any type of processing device capable of executing the techniquesdescribed herein. In one example, database 114 may be configured tostore program instructions (e.g., software instructions) that areexecuted by processor 112 to carry out the techniques described herein.In other examples, the techniques described herein may be executed byspecifically programmed circuitry of processor 112. Processor 112 maythus be configured to execute the techniques described herein. Processor112, or any other processes herein, may include one or more processors.

User interface 140 may include a display screen and/or include othertypes of output capabilities. For example, user interface 140 mayinclude any number of visual (e.g., display devices, lights, etc.),audible (e.g., one or more speakers), and/or tactile feedback devices.In some examples, user interface 140 may represent both a display screen(e.g., a liquid crystal display or light emitting diode display) and aprinter (e.g., a printing device or module for outputting instructionsto a printing device). User interface 140 may be configured to allowusers to view and select one or more medical documents from healthinformation 130 for a plurality of patients, for example. User interface140 may be configured to receive user input and communicate the userinput to user interface 140, processor 112, and/or to database 114. Userinterface 140 may further be configured to receive user input to developand/or apply analytical models to health information 130. The differentcomponents shown in FIG. 1 may be directly connected or interconnected,and in some examples, may use a data bus to facilitate communicationbetween the components.

Health information 130 for a plurality of patients may include anyinformation relating to interaction between patients and medicalfacilities or professionals. In some examples, health information 130for a plurality of patients may also, or alternatively, includeinformation collected or generated by medical device interaction withone or more patients. For example, during a visit to a facility orprofessional, a facility or medical professional may generate reportsregarding a patient's health status, current treatments and outcomes,and/or results of any medical tests conducted for the patient.Generally, these medical documents may be grouped into a file identifiedas a health record for the specific patient. Each report may includemultiple pages, portions, or sections, detailing the various aspects ofthe patient and/or the patient's visit. In some facilities, thesepatient health records may be kept as paper files. In some facilities,the paper records may be scanned and stored in a computer or computermemory as a digital health record that includes the medical documents.

In some examples, processor 112 may parse the medical documents orotherwise identify features or terms that may correspond to one or moremedical codes. Processor 112 may then assign and output the generatedone or more medical codes for each medical document to update healthinformation within database 114.

Database 114 may further be configured to store health informationsubset 136, which does not include PHI. For example, health informationsubset 136 may represent a de-identified subset of data on whichanalytics can be performed to set up and test analytics programs, whichwill later be run against the complete data set with PHI. For example,by providing a statistically representative sample of health informationwithout PHI within health information subset 136, an analyst may freelyuse that information to develop analytic models without the need torestrict access. However, by maintaining the original health informationwithin health information 130, the analyst may test and apply the modelsdeveloped using the de-identified subset of data, e.g., healthinformation subset 136, to the full dataset of health information 130including PHI 132.

In some examples, database 114 may further be configured to storeanalytic model 138. Analytic model 138 represents a program foranalyzing health information such as health information 130 and/orhealth information subset 136. In some examples, processor 112 mayreceive instructions for the development and application of analyticmodel 138 via user interface 140. In various examples, computer system110 may output a results summary of the application of analytic model138 via user interface 140 and/or update health information 130 and/orhealth information subset 136 with the results of analytic model 138.

Database 114 includes one or more physically separate databases, e.g.,stored in a memory. For example, health information 130 may bedistributed across a number of physically separate computer systems. Insome examples, the volume of health information 130 may be too large fora single server to store or process in a reasonable period of time. Asan example, database 114 may include “NoSQL” database systems.

Likewise, processor 112 may also include one or more physically separateprocessors. For example, processing of health information 130 may bepartitioned in parallel operations that are distributed to the sameservers where the data partitions are stored, to limit data movementacross network(s) connecting physically separate databases of database114. As an example, processor 112 may incorporate Map-Reduce systems,such as Hadoop®.

As discussed in further detail below, processor 112 may apply one ormore statistical operations and/or apply analytical models to healthinformation 130. For example, processor may apply statisticaloperations, including sums, counts, means, medians, standard deviations,regressions, etc., through machine-learning techniques. Examplemachine-learning techniques include the construction of neural networks,decision tress, support vector machines, etc.

In addition to the techniques mentioned above for development andapplication of analytical models of health information, such as healthinformation with PHI, discussed below are additional techniques that canbe roughly described in six different categories. Note that any of thetechniques below can be combined with one another and/or combined withthe additional techniques discussed above. As mentioned above, ingeneral, the most valuable techniques for enabling big data analyticswhile complying with patient privacy laws attempt to utilize the largedata volumes available for development and application of analyticalmodels as well as mitigate the data quality issues associated withde-identification, and reduce the exposure of PHI to human analysts.

A first category of techniques for development and application ofanalytical models of health information, such as health information withPHI, is combining the operational and analytics data storage to whateverextent possible. This limits persistent copies of data, reducing pointsof failure, and focusing logging and other regulatory infrastructure ona smaller number of functional points.

A second category of techniques for development and application ofanalytical models of health information, such as health information withPHI, is providing a de-identified subset of data on which analytics canbe performed to set up and test the analytics programs, which will laterbe run against the complete data set with PHI. For example, by providinga statistically representative sample of health information without PHI,an analyst may freely use that information to develop analytic modelswithout the need to restrict access. However, by maintaining theoriginal health information, the analyst may test and apply the modelsdeveloped using the de-identified subset of data, i.e., a subset of thehealth information with the PHI removed, to the full dataset of healthinformation including the PHI.

A third category of techniques for development and application ofanalytical models of health information, such as health information withPHI, is providing the ability to view the analytics results on specific,tracked instances of PHI within the platform, so PHI does not need leavethe platform even when the analyst must view the data to refine ananalysis program. In this way, access to PHI, where necessary, islimited and may be logged for regulatory purposes.

A fourth category of techniques for development and application ofanalytical models of health information, such as health information withPHI, is providing the ability to submit an analytics program into thesystem, where it runs on the entire PHI, but output results are onlystatistical summaries viewable by the analyst. Patient privacyregulations such as HIPAA typically consider statistical summaries ofdata to be non-PHI where it is not possible to derive PHI for anyparticular patient from the data. In addition, at this stage, data maybe filtered for right-to-use. That is, if some of the data includespersonally identifying information, but the patient has waived the rightto privacy, the analyst may be able to view the personally identifyinginformation for patients that have waived the right to privacy.

A fifth category of techniques for development and application ofanalytical models of health information, such as health information withPHI, is providing the ability for analytic programs to be submitted tothe system and run, limiting their outputs, which may include PHI, toproduction system uses where that PHI is legitimately usable to improvethe care or other outcomes for the patient. For example, an analyst mayrun a model against health information for a multitude of patients, andthen some of the patient files may be updated in accordance with theresults of the model in a manner that restricts access to the PHI by theanalyst.

A sixth category of techniques for development and application ofanalytical models of health information, such as health information withPHI, is tracking data right-to-use terms, and automatically filteringdata for right-to-use. For example, analysts may designate the purposeof their analysis, which is then matched against individual data setsand their corresponding right-to-use terms.

These six categories of techniques for development and application ofanalytical models of health information, such as health information withPHI, as well as additional techniques for development and application ofanalytical models of health information are discussed in further detailbelow with respect to FIGS. 2-6 .

FIG. 2 is a conceptual illustration of an enhanced patient record store200, which provides a data service interface 202 and combined datastorage system storing health information, such as health informationincluding PHI. Enhanced patient record store 200 functions to combineoperational data storage for operational healthcare system 220 andanalytics data storage for analytics grid 210. Thus, enhanced patientrecord store 200 reduces the number of copies of health informationdata, which may reduce points of failure, and facilitate compliance withpatient privacy regulations, e.g., by limiting the number of databasesin which logging and other regulatory compliance infrastructure isrequired.

Health information, such as health information including PHI may bestored in a NoSQL distributed storage system 204. Optionally, enhancedpatient record store 200 may duplicate portions of the data in arelational database system (RDBMS) 206 to perform transactionaloperations. Data may also be duplicated to data warehouse 208. Forexample, data warehouse 208 may implement a star schema and may supportlongitudinal analytics. Analytics grid 210 may run directly against theoperational data, such as against NoSQL storage 204. In some examples,analytics jobs may be given lower priority than operational activitiesto limit the impact of analytics grid 210 on operational healthcaresystem 220.

In contrast to enhanced patient record store 200, other database systemsmay separate operational and analytic storage data storage. However,combining data storage for operational healthcare system 220 andanalytics grid 210, as provided by enhanced patient record store 200,may provide one or more advantages to having separate database systemsfor operational and analytic healthcare information data storage.

As previously mentioned, combining data storage for operationalhealthcare system 220 and analytics grid 210 limits the number ofdatabases in which logging and other regulatory complianceinfrastructure is required. Combining data storage for operationalhealthcare system 220 and analytics grid 210 may also increaseperformance of both operational healthcare system 220 and analytics grid210 by combining resources to produce a wider distribution of dataacross servers, increasing parallelism. In part, this may be achieved byusing a NoSQL storage approach, minimizing or eliminating interfacesrequired to assemble a complete patient record. In addition, combiningdata storage for operational healthcare system 220 and analytics grid210 may facilitate the ability to unify off-line analytics andoperational analytics, e.g., the development of apotentially-preventable readmission (PPR) model and its deployment inproduction, without supporting multiple systems and multiple points ofPHI-leakage risk.

In some examples, any or all of the components of enhanced patientrecord store 200 may be duplicated, in whole or in part, to isolateanalytics grid 210 from operational healthcare system 220. In the sameor different examples, NoSQL storage 204 may be eliminated. However,such modifications would lead to a system that includes additionalcopies of PHI, thus increasing the number of databases in which loggingand other regulatory compliance infrastructure is required.

FIG. 3 illustrates example techniques for producing a de-identifiedanalytics subset of patient data 336 from health information 330, whichincludes PHI 332, suitable for analytical model construction andevaluation.

As illustrated in FIG. 3 , a random sample of health information 331 isselected from health information 330. For example, the random sample ofhealth information 331 may be associated with a random sample ofpatients associated with health information 330. The random sample ofhealth information 331 is de-identified in that PHI is removed from therandom sample of health information 331.

In particular, as illustrated in FIG. 3 , the random sample of healthinformation 331 may be de-identified according to three differentprocesses. In other processes, additional or fewer techniques may beused to de-identify the random sample of health information 331.

In a first technique, quantitative PHI filter 333 may strip quantitativedata from PHI fields within structured data, which are replaced withdummy values that cannot be reverse-engineered to derive the originaldata.

In a second technique, unstructured data will be pass filter 334, whichretains only known anonymous data, such as general clinical concepts,phrases occurring in multiple patient records and the like. Theunstructured data may be only a small subset of the data, but thistechnique may be valuable in that anonymity can be assured without humanreview. Examples techniques for filtering unstructured data aredisclosed in U.S. Pat. App. No. 61/904,213, filed Nov. 14, 2013,entitled “Systems and Methods for Obfuscating Data Using ObfuscationTable” and U.S. Pat. App. No. 61/904,223, filed Nov. 14, 2013, entitled“Systems and Methods for Obfuscating Data Using Dictionary.” The entirecontents of each of these patent applications is incorporated byreference herein.

Additionally, unstructured data may be be de-identified by humanreviewers 335, which may eliminate all references to identifiableinformation. De-identified analytics subset of patient data 336 resultsfrom health information sample 331 following processes 333, 334 and 335.

The techniques of FIG. 3 may be applied to a centralized database ofhealth information such as database 114. In this manner, the techniquesof FIG. 3 may be used by analysts to amortize the cost producingde-identified analytics subset of patient data 336 across multipleprojects.

In the process of developing analytic models, analysts may find value inlooking at some of the “raw” data to get a sense for how the data isstructured, what kinds of features appear to be important, to diagnoseerrors in the model, or for other reasons. In environments where dataaccess by analysts is not a concern, this may occur by quickly graphingor printing reports with subsets of the data, or paging through pages ofunstructured data. However, in the case of health information includingPHI, such as health information 330, providing unfettered access to PHIincreased risk exposure to patient privacy violations from potentiallyviewing more data. The techniques of FIG. 3 allow de-identifiedanalytics subset of patient data 336 to include as much healthinformation as possible from health information sample 331 to aidanalysts in the development and application of health informationmodeling.

As new patient data for existing patients is added to health information330 in the normal course of application operations, if those patientsare part of the random subset associated with health information sample331, the new data may also be sent through processes 333, 334 and 335.In this manner, de-identified analytics subset of patient data 336 maybe updated in conjunction to updates to health information sample 331.

In addition, as health information for new patients are added to healthinformation 330, a random sample of the new patients may be added tohealth information sample 331, and that data may be sent throughprocesses 333, 334 and 335. In this manner, de-identified analyticssubset of patient data 336 may be updated in conjunction with newpatients being added to health information 330.

The techniques of FIG. 3 may be applied to the full dataset of healthinformation 130 (FIG. 1 ), including PHI 132, to create healthinformation subset 136 (FIG. 1 ). For example, by providing astatistically representative sample of health information without PHI,such as health information subset 136 or de-identified analytics subset336, an analyst may freely use that information to develop analyticmodels without the need to restrict access. However, by maintaining theoriginal health information, such as health information 130 or healthinformation 331, the analyst may test and apply the models developedusing the de-identified subset of data, i.e., a subset of the healthinformation with the PHI removed, to the full dataset of healthinformation including the PHI.

The techniques of FIG. 3 provide a data set, de-identified analyticssubset 336, against which general analytics can be performed and reducethe need to access or view PHI in the first place. The techniques ofFIGS. 4-6 include the execution of models in an environment where theanalyst does not have PHI access, even though the models may be executedagainst healthcare information that includes PHI.

In the normal course of most analytics activities, the full data setavailable for analysis exists in a place where the human analyst canfreely view all of the data, both in its raw form, and as it isprocessed by the analytics model being developed. The default assumptionnecessary is that the human analyst may have viewed any of the raw data,despite the fact that the analyst can only practically view a smallsubset of a very large raw data set (typically millions, billions, ortrillions of elements). Because the wide variety of low-level tools usedto browse and analyze the data do not themselves do access tracking, itis not practical to log individual record access. This impracticality isacceptable in environments where the data is not sensitive in nature,such as a marketing researcher analyzing purchasing data for hercompany. However, with respect to health information that includes PHI,patient privacy regulations place restrictions on access to PHI as wellas requirements for logging access to PHI.

FIG. 4 is an operational diagram representing analyst interaction with acomputer system that logs analyst access to PHI 432 within healthinformation 430 to facilitate compliance with patient privacyregulations. The techniques of FIG. 4 provide analyst 460 the ability toview the analytics results on specific, tracked instances of PHI withinthe platform, so PHI does not need leave the platform even when theanalyst must view the data to refine an analysis program. In this way,access to PHI, where necessary, is limited and easily logged forregulatory purposes.

As shown in FIG. 4 , analyst 460 interacts with user interface 450 toapply and develop analytical models for health information 430, whichincludes PHI 432. The system of FIG. 4 provides a search engine 442 thatallows analyst 460 to search for patients and documents matchingspecific criteria, where the resulting patients and documents areinitially displayed in a list showing only de-identified information,such as obfuscated internal patient identifiers, details on which searchterms resulted in hits, etc. Any indices on a data set with PHI islikely to include PHI, therefore the indices themselves are not visibleto the user. By exposing the search capabilities through the userinterface 450 and filtering the search results of PHI, the analyst canget the benefit of advanced search to identify specific records forreview, minimizing the need for the analyst to page through data andtherefore increase PHI exposure.

When analyst 460 accesses a particular patient record, the data may bepresented as viewable to analyst 460, the internal markup ofunstructured content is available, as is the results of any of theanalysts' models already run against this data, so the analyst caninterpret and refine models using user interface 450. However, userinterface 450 does not provide any option for extracting PHI from thesystem via user interface 450. For example, the results of analystrequest to accesses a particular patient record including PHI orotherwise view PHI may be presented as an image rather than HTML orother text that could be easily saved and processed via user interface450. For example, user interface 450 may be a web browser.

In addition, the system of FIG. 4 may operate to log every access to PHIby analyst 460. In addition, the system of FIG. 4 may also furtherrestrict access to PHI by analyst 460 based on the securityauthorization of the analyst.

FIG. 5 is an operational diagram representing analyst interaction with acomputer system that facilitates analytic modeling of health informationwhile restricting analyst access to PHI 532 within the healthinformation 530. In particular, the techniques of FIG. 5 provide analyst560 the ability to submit an analytics program, i.e., job queue 542,into the analytics grid 544, where it runs on the entire volume ofhealth information 530, including PHI 532, but output results are onlystatistical summaries 546 viewable by the analyst. Statistical summaries546 do not include PHI in that patient privacy regulations such as HIPAAtypically consider statistical summaries of data to be non-PHI where itis not possible to derive PHI for any particular patient from the data.In addition, at this stage, data may be filtered for right-to-use. Thatis, if some of the data includes personally identifying information, butthe patient has waived the right to privacy, the analyst may be able toview the personally identifying information for patients that havewaived the right to privacy.

In this manner, analyst 560 submits a model to job queue 542, where themodel has access to health information 530, including PHI 532, butanalyst 560 does not have access to the models while they run againsthealth information 530, including PHI 532. The models return statisticalsummaries 546, which in general are not considered PHI, and thus arereturned to analyst 560. The exact content of model results returned toanalyst 560 may be tracked and logged, so later audits can confirm thatno PHI was accessed, exposed, or removed from the system.

In some examples, analytics grid 544 may include a large array ofcomputational nodes, which may overlap with the servers storing healthinformation 530, and health information 530 may be in NoSQL form. Topreserve restricted access to PHI 532, analyst 560 does not have directaccess to analytics grid 544. As one example, analytics grid 544 may berunning map-reduce software such as Hadoop®, and/or may also run otherstatistical analysis software tools.

The data extracted from health information 530 may be filtered forright-to-use. In many cases, the statistical results 546 may be used infuture models. For instance, a PPR model submitted might consist of thealgorithms to generate features the analyst believes are indicative ofPPR risk from patient records, along with an indicator of readmission.Using this set of input features and output target, a machine-learningalgorithm is run to train a model such as a neural network or a supportvector machine. The output of the run is the trained weights of themodel; this itself is a new model that, in conjunction with thealgorithms for input feature generation, can be used to analyze newpatient records.

FIG. 6 is an operational diagram representing analyst interaction with acomputer system that facilitates updating of health information 630,which is associated with a plurality of patients while restrictinganalyst access to PHI 632 within the health information. The techniquesof FIG. 6 allow analyst 660 the ability to submit analytic programs toproduction job queue 642 and run on analytics grid 644, limiting theiroutputs, which may include PHI, to production system uses, by updatingor augmenting patient information within health information 630according to the results of the analysis. The analyst does not need tosee any PHI to effect the deployment of the analytic model to theoperational environment. Updating or augmenting patient informationwithin health information 630 is a legitimately use of PHI 632 toimprove the care or other outcomes for the patient.

As an example, having built a model that analyst 660 believes meets theneeds of a production application, analyst 660 may submits the model toproduction job queue 642 and run on analytics grid 644. The model may beautomatically applied to new records within health information 630 witha frequency defined by analyst 660 within the model. For instance,analyst 660 might indicate that analytics grid 644 should run the modelevery night against new and changed patient records, and update oraugment patient information within health information 630 according tothe results of the nightly analysis. In this production process, thereis no need for the analyst to access PHI 632.

In the same or different examples, data within health information 630run through production models may be filtered to only those data setswhere there is a right-to-use the data in the health information 630 forthe modeled purpose. For example, analysts may designate the purpose oftheir analysis, which is then matched against individual data sets andtheir corresponding right-to-use terms. In many cases, this matching ofdata sets and corresponding rights-to-use terms may occur because aclient has specifically contracted for the model results.

In some examples, the purpose of the model is specified. Such purposesmay include modeling for products sold by a client, conducting strategicresearch on patterns in the data set, such as mentions of particularproducts, conditions, etc., supporting marketing activities,establishing specific norms and benchmarks, and conducting new modelresearch for future products. Additional categories may be added in thefuture, and an analyst can add detail where needed, e.g., for newresearch, the particulars of the research, etc.

In the same or different examples, the set of clients, if any, for whicha model is being run may also be specified. For example, a contractpermitting access of health information may limit use of data topurposes specifically supporting the client.

For this reason, health information may be tagged with the source of theinformation, such as when a specific client is tagged as such. Some datamay not be associated with a specific client, such as third party norms.In some examples, right-to-use information for data may include:products and activities where data use is allowed, products andactivities where data use is disallowed, products and activities wheredata use is allowed if the activity is directly supporting the customer,and products and activities where data use is restricted in some other,contract-specific way.

Health information for analytic modeling may be filtered for thedeclared purpose of the model and for clients for which the model is tobe applied. In addition, client data may have contract term for aparticular modeling activity, or the client data may have a contractedterm for modeling activity and the legal right to use has beenestablished for this particular model against this client's data.

A second set of checks may be conducted prior to running a model, toprevent moving forward with any analytics until certain conditions aremet. In such examples, for each data set (which may cover multipleclients), two items can be established. First that the set of legitimateuses of the data in terms of known modeling activities is defined. Forinstance, many PHI data sets may prohibit the use of data for marketing.As another example, user training or certification may be requiredbefore the data set can be used. For each analyst, the system may track(or access from an external training system) which training programs theanalyst has completed, including expiration dates. An attempt to conductan analysis against a data set for which the analyst has not completednecessary training may be blocked, with information about the requiredtraining provided back to the analyst.

Example 1

By way of illustration consider the following example analysis todetermine the risk for each of a plurality of patients for a“potentially preventable re-admission” or PPR. In this example, ananalyst is trying to develop a statistical model to predict eachpatient's risk of re-admission, which is a significant driver ofincreased costs and is itself a lower-quality result for a patient.

Using the techniques disclosed herein, the analyst may access a computersystem that combines operational and analytics data storage, such asthat shown in FIG. 2 . In this manner, the patient data for a pluralityof patients is already being gathered in a system supporting hospitaloperations such as coding, and this same data storage is used as thebasis for the PPR analytics.

The analyst may initially designate that their analysis relates to PPR,and before the analyst views data and before a model is trained or runagainst data, the data is filtered to only that data legitimatelyallowing PPR modeling. Thus, available health information may befiltered for right-to-use restrictions.

The analyst may develop an initial algorithm to train a PPR model fromclinical data. The analyst may test the model on the de-identifiedsubset to validate that the training algorithm is looking at the fieldsthey expect to be relevant to the PPR analysis. Such a de-identifiedsubset may be created in accordance with the techniques of FIG. 3 .

Following the initial development of the model, the analyst may testwhether proximity to the hospital is a factor in PPRs, and to do sowants to ensure addresses (a component of PHI) are being processedcorrectly. The analyst may submit a model to the system and accesses PHIwithin three patient records, confirming that the address is beingproperly handled. The records never leave the analytics system, theanalyst's access of the three records is properly logged (along with itspurpose), and the analyst is exposed to a minimal amount of PHI insteadof the entire data set. Such techniques are also described moregenerally above with respect to FIG. 4 .

Following further development of the model, the analyst may submit thedebugged PPR model to the system to be trained using all availablehealth information. Training may include: calculating regressions,computing neural network weights, and additional techniques. The modelgets the benefit of all data (filtered for right-to-use for PPR models)in its training. The resulting statistics, showing which clinical recordfeatures combined with what weights to predict PPR probability, may bepresented as a summary to the analyst, who can then refine and re-submitthe model as needed. In accordance with the techniques of FIG. 5 , theanalyst does not need to access PHI when not necessary.

Having refined the model, the analyst may submit a final PPR model toproduction, to be run against all new patients going forward. For eachpatient, an individual PPR probability is produced and made available tothe operational system and viewable by case managers, but not theoriginal analyst. In accordance with the techniques of FIG. 6 , healthinformation may be updated without analyst access to PHI.

Thus, the example 1 illustrates how the techniques described withrespect to FIGS. 2-6 may be combined to enabling big data analyticswhile complying with patient privacy laws and minimizing exposure of PHIas disclosed herein.

FIG. 7 is a flow diagram illustrating an example technique for producinga de-identified analytics subset of health information suitable foranalytical model construction and evaluation. For example, thetechniques of FIG. 7 may be used to produce health information subset136 (FIG. 1 ) or de-identified analytics subset of health information336 of FIG. 3 . For clarity, the techniques of FIG. 7 are discussed withrespect to computer system 110 of FIG. 1 .

First, processor 112 of computer system 110 accesses health information130 within databases 114 for a plurality of patients (702). Healthinformation 130 includes PHI 132.

Then, processor 112 randomly selects a subset of health information 130from databases 114 (704). The subset of the health informationcorresponds to a subset of the plurality of patients.

Processor 112 then removes PHI from the subset of health information toproduce a de-identified analytics subset of patient data 136 (706).De-identified analytics subset of patient data 136 is suitable foranalytical model construction and evaluation. Removing the protectedhealth information from the health information for the randomly-selectedsubset of the plurality of patients to produce the de-identifiedanalytics subset of patient data suitable for analytical modelconstruction and evaluation may include removing data from fieldsidentified as including protected health information and filteringunstructured data to remove unstructured protected health information asdescribed with respect to FIG. 3 . Producing the de-identified analyticssubset of patient data suitable for analytical model construction andevaluation may further comprise receiving, from a human user via userinterface 140, indications of additional protected health informationwithin the health information for the randomly-selected subset of theplurality of patients after removing the protected health informationfrom the health information, and removing the additional protectedhealth information indicated by the human user from the healthinformation for the randomly-selected subset of the plurality ofpatients. Once produced, processor 112 may store de-identified analyticssubset of the patient data 136 in databases 114 (708).

In some examples, processor 112 may present a representation ofde-identified analytics subset of the patient data to a user via userinterface 140 for analytical model construction and evaluation.

In addition, following an update to health information 130 withindatabases 114, the update including health information for additionalpatients, processor 112 may randomly select health information 130corresponding to a subset of the additional patients. Processor 112 mayremove PHI 132 from the health information for the randomly-selectedsubset of the additional patients and add the health information 130 forthe randomly-selected subset of the additional patients without theremoved protected health information to the de-identified analyticssubset of patient data 136 to produce an updated de-identified analyticssubset of patient data. Processor 112 may store the updatedde-identified analytics subset of the patient data in databases 114.

In some examples, processor 112 may further receive an analytical modelbased on de-identified analytics subset of patient data 136, and applythe analytical model to health information 130 for the plurality ofpatients. For example, the analytical model may have been developedbased on de-identified analytics subset of patient data 136 prior to itsapplication to health information 130 for the plurality of patients.Processor 112 may output a summary of the results of the application ofthe analytical model to the health information with the protected healthinformation for the plurality of patients via user interface 140. Userinterface 140 may restrict user access to the PHI 132, e.g., asdescribed with respect to FIG. 5 .

As another example, processor 112 may access an analytical model 138,which may be based on de-identified analytics subset of patient data136, and apply analytical model 138 to health information 130 for theplurality of patients. For example, analytical model 138 may have beendeveloped based on de-identified analytics subset of patient data 136prior to its application to health information 130 for the plurality ofpatients. Processor 112 may compare the result of the application ofanalytical model 138 to the de-identified analytics subset of patientdata 136 to a result of the application of the analytical model to thehealth information 130 for the plurality of patients, and present asummary of the comparison via user interface 140. User interface 140 mayrestrict user access to the PHI 132, e.g., as described with respect toFIG. 5 and FIG. 6 .

In some examples, processor 112 may receive, from a human user via userinterface 140, a request to access a portion of PHI 132 removed toproduce de-identified analytics subset of patient data 136. In responseto the request, processor 112 may present the requested protected healthinformation to the human user via user interface 140, and store a recordof the request to access the portion of PHI.

FIG. 8 is a flow diagram illustrating example techniques for analyzinghealth information associated with a plurality of patients whilerestricting access to PHI within the health information. For example,the techniques of FIG. 8 may generally correspond to the techniquesdescribed with respect to FIG. 5 and FIG. 6 . For clarity, thetechniques of FIG. 8 are discussed with respect to computer system 110of FIG. 1 .

First, processor 112 of computer system 110 accesses health information130 within databases 114 for a plurality of patients (802). Healthinformation 130 includes PHI 132. Processor 112 may also accessanalytical model 138 within databases 114 (804).

Processor 112 may receive instructions, via user interface 140, to applyanalytical model 138 to health information 130 for each of the pluralityof patients (806). PHI 132 is isolated from user interface 140 torestrict access to PHI 132. In some examples, health information 130including PHI 132 may be isolated from user interface 140. Processor mayapply model 138 to health information 130 for each of the plurality ofpatients (808). Processor may also store a result of the analyticalmodel to databases 114 (810).

In some examples, processor 112 may present, via the user interface 140,a summary of the updated health information, wherein the summary of theupdated health information excludes any of the protected healthinformation. In some such examples, summary of the result of theanalytical model may include statistical summary of health informationresulting from the analytical model to facilitate user evaluation of theanalytical model.

In the same or different examples, processor 112 may update healthinformation 130 associated with at least some of the plurality ofpatients according to the results of the analytical model. For example,updating health information associated with at least some of theplurality of patients according to the results of the analytical modelmay include updating patient care information for at least some of theplurality of patients. As another example, updating health informationassociated with at least some of the plurality of patients according tothe results of the analytical model include updating a patient healthevent risk assessment for at least some of the plurality of patients.

In some examples, processor 112 may receive, from a human user via userinterface 140, a request to access a portion of PHI 132 removed toproduce de-identified analytics subset of patient data 136. In responseto the request, processor 112 may present the requested protected healthinformation to the human user via user interface 140, and store a recordof the request to access the portion of PHI.

The techniques of this disclosure may be implemented in a wide varietyof computer systems, such as distributed computer systems, which mayinclude any number of servers, laptop computers, desktop computers,notebook computers, tablet computers, hand-held computers, smart phones,and the like. Any components, modules or units have been described toemphasize functional aspects and do not necessarily require realizationby different hardware units. The techniques described herein may also beimplemented in hardware, software, firmware, or any combination thereof.Any features described as modules, units or components may beimplemented together in an integrated logic device or separately asdiscrete but interoperable logic devices. In some cases, variousfeatures may be implemented as an integrated circuit device, such as anintegrated circuit chip or chipset.

If implemented in software, the techniques may be realized at least inpart by a computer-readable storage medium comprising instructions that,when executed in a processor, performs one or more of the methodsdescribed above. The computer-readable storage medium may comprise atangible computer-readable storage medium and may form part of acomputer program product, which may include packaging materials. Examplecomputer-readable storage media may include random access memory (RAM)such as synchronous dynamic random access memory (SDRAM), read-onlymemory (ROM), non-volatile random access memory (NVRAM), electricallyerasable programmable read-only memory (EEPROM), FLASH memory, andmagnetic or optical data storage media. The computer-readable storagemedium may also comprise a non-volatile storage device, such as a harddisk, magnetic tape, a compact disk (CD), digital versatile disk (DVD),Blu-ray disk, holographic data storage media, or other non-volatilestorage device. The computer-readable storage medium may be referred toas a non-transitory medium. The term “non-transitory” may indicate thatthe storage medium is not embodied in a carrier wave or a propagatedsignal. In certain examples, a non-transitory storage medium may storedata that can, over time, change (e.g., in RAM or cache).

The term “processor,” as used herein may refer to any of the foregoingstructure or any other structure suitable for implementation of thetechniques described herein. In addition, in some aspects, thefunctionality described herein may be provided within dedicated softwaremodules or hardware modules configured for performing the techniques ofthis disclosure. Even if implemented in software, the techniques may usehardware such as a processor to execute the software, and a memory tostore the software. In any such cases, the computers described hereinmay define a specific machine that is capable of executing the specificfunctions described herein. Also, the techniques could be fullyimplemented in one or more circuits or logic elements, which could alsobe considered a processor.

Various examples have been described. These and other examples arewithin the scope of the following claims.

What is claimed is:
 1. A method for analyzing patient data, the methodcomprising: accessing, by a computer system, one or more databasescomprising health information data, including protected healthinformation, for a plurality of patients; accessing, by the computersystem, an analytical model; receiving, by the computer system via auser interface, instructions to apply the analytical model to healthinformation for each of the plurality of patients, de-identifying, bythe computer system, the protected health information in the healthinformation data; applying, by the computer system, the analytical modelusing a machine-learning algorithm to the health information data;updating, by the computer system, the health information data associatedwith at least some of the plurality of patients according to the resultof the applying; and storing a result of the analytical model to the oneor more databases.
 2. The method of claim 1, further comprisingpresenting, by the computer system via the user interface, a summary ofthe result of the analytical model, wherein the summary of the result ofthe analytical model excludes any of the protected health information.3. The method of claim 2, wherein the summary of the result of theanalytical model includes a statistical summary of the healthinformation data resulting from the analytical model to facilitate userevaluation of the analytical model.
 4. The method of claim 1, whereinthe health information data, including the protected health information,for the plurality of patients is isolated from the user interface. 5.The method of claim 1, further comprising updating, by the computersystem, within the one or more databases, the health information dataassociated with at least some of the plurality of patients according tothe results of the analytical model.
 6. The method of claim 5, whereinupdating, within the one or more databases, the health information dataassociated with at least some of the plurality of patients according tothe results of the analytical model includes updating patient careinformation for at least some of the plurality of patients.
 7. Themethod of claim 5, wherein updating, within the one or more databases,the health information data associated with at least some of theplurality of patients according to the results of the analytical modelincludes updating a patient health event risk assessment for at leastsome of the plurality of patients.
 8. The method of claim 1, furthercomprising: receiving, via the user interface, a request to accessprotected health information within one or more databases; presenting,by the computer system via the user interface, the requested protectedhealth information via the user interface; and storing a record of therequest to access the protected health information within the one ormore databases.
 9. A computer system for storing and analyzing healthinformation for a plurality of patients comprising: one or moredatabases comprising health information data, with protected healthinformation, for a plurality of patients; a user interface; and one ormore processors configured to de-identify the protected healthinformation in the health information data, apply an analytical modelusing a machine learning algorithm to patient data for each of theplurality of patients based on instructions received via the userinterface, update, by the computer system, the health information dataassociated with at least some of the plurality of patients according tothe result of the applying the analytical model using a machine learningalgorithm to patient and store a result of the analytical model to theone or more databases, wherein the protected health information for theplurality of patients is isolated from the user interface.
 10. Thecomputer system of claim 9, wherein the one or more processors arefurther configured to present, via the user interface, a visualrepresentation of the result of the analytical model, wherein the visualrepresentation of the result of the analytical model excludes any of theprotected health information.
 11. The computer system of claim 10,wherein the visual representation of the result of the analytical modelincludes a statistical summary to facilitate user evaluation of theanalytical model.
 12. The computer system of claim 9, wherein the one ormore processors are further configured to update, within the one or moredatabases, the health information data associated with at least some ofthe plurality of patients according to the results of the analyticalmodel.
 13. The computer system of claim 12, wherein updating, within theone or more databases, the health information data associated with atleast some of the plurality of patients according to the results of theanalytical model includes updating patient care information for at leastsome of the plurality of patients.
 14. The computer system of claim 12,wherein updating, within the one or more databases, the healthinformation data associated with at least some of the plurality ofpatients according to the results of the analytical model includesupdating patient health event risk assessments for at least some of theplurality of patients.
 15. The computer system of claim 9, wherein theone or more processors are further configured to: receive, via the userinterface, a request to access protected health information within oneor more databases; present, via the user interface, the requestedprotected health information via the user interface; and store a recordof the request to access the protected health information within the oneor more databases.
 16. A non-transitory computer-readable storage mediumcomprising instructions that, when executed, cause one or moreprocessors to: access one or more databases comprising healthinformation data, with protected health information, for a plurality ofpatients; receive, via a user interface, instructions to apply ananalytical model to health information for each of the plurality ofpatients; de-identify the protected health information in the healthinformation data; apply the analytical model using a machine learningalgorithm to the health information data for each of the plurality ofpatients; update the health information data associated with at leastsome of the plurality of patients according to the result of theapplying; and store a result of the analytical model to the one or moredatabases.
 17. The computer-readable storage medium of claim 16,comprising further instructions that, when executed, cause the one ormore processor to present, via the user interface, a summary of theresult of the analytical model, wherein the summary excludes any of theprotected health information.
 18. The computer-readable storage mediumof claim 16, comprising further instructions that, when executed, causethe one or more processor to isolate the protected health information,for the plurality of patients from the user interface.
 19. Thecomputer-readable storage medium of claim 16, comprising furtherinstructions that, when executed, cause the one or more processor toupdate, within the one or more databases, the health information dataassociated with at least some of the plurality of patients according tothe results of the analytical model.
 20. The computer-readable storagemedium of claim 16, comprising further instructions that, when executed,cause the processor to: receive, via the user interface, a request toaccess protected health information within one or more databases;present, via the user interface, the requested protected healthinformation via the user interface; and store a record of the request toaccess the protected health information within the one or moredatabases.